| NPI | 1932141371 |
|---|---|
| Former Name | BRIDGETTE R JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9435) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 9985) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2021-06-15 |